The impact of COVID-19 has led to widespread concerns about its unique effects on college students' mental health. Surveys of college students conducted after March 2020 have repeatedly suggested that psychological distress among college students has increased. CCMH data, representing nearly 50,000 treatment-seeking students at 140+ institutions, suggests that the impact of COVID-19 on college students' mental health is considerably more nuanced than generally reported. To examine the impact of COVID-19 on mental health more thoroughly, using a broader range of longitudinal clinical data, CCMH will offer a five-part blog series to describe the impact of COVID-19 on college student mental health from multiple perspectives. While surveys offer an important perspective and provide an immediate snapshot of data, CCMH data is gathered methodically over time and then examined retrospectively. While this method requires patience for data to accumulate, it also provides a more robust population-level perspective (among students seeking services).

The 2020 Annual Report expands on the 2019 Annual Report that introduced the concept of the Clinical Load Index (CLI). The 2020 Annual Report provides an updated CLI distribution representing more colleges and universities and describes differences in counseling center practices at the low and high ends of the CLI distribution. 

In March 2020, college counseling centers, along with many other healthcare facilities across the United States, encountered the unprecedented challenge of rapidly transitioning to tele-services in response to COVID-19. To accomplish this feat, counseling centers promptly transformed their in-person care to tele-services in a matter of days/weeks. While most college counseling centers continue to provide telehealth during the 2020-2021 academic year, many questions have emerged regarding the sustained utilization of tele-services within college counseling centers in the future. Some of the most common questions include: (a) will tele-services, at least in some capacity, become a permanent part of counseling center services?; (b) will some colleges/universities delegate a portion of traditional in-person counseling services to external telehealth vendors?; and (c) given tele-services are the most prominent current mode of treatment, what proportion of students seeking counseling center services possess risk factors that make them a poor fit for tele-services?

Staff who work in college counseling centers are aware that many clients discontinue services only to return to treatment at a later time. Thus, a longstanding question within the field of collegiate mental health is how often do clients return for subsequent courses of services and are there signs or predictors that might signal if a client is more likely to return to services. To examine this further at CCMH, Kilcullen et al. (2020) evaluated the rates at which clients return for additional courses of therapy in university counseling center (UCC) settings and a range of associated variables.

Recent national events have renewed our collective focus on racial injustice and the experiences of discrimination and racial, cultural and ethnic concerns. In an effort to contribute to this dialogue, CCMH took a closer look at the frequency in which students initiate counseling with discrimination and/or racial, cultural or ethnic concerns as primary presenting problems. To accomplish this, CCMH examined responses from the Clinician Index of Client concerns (CLICC), which is a checklist of possible presenting problems that is completed by the clinician after evaluating a student who is seeking mental health care. “Discrimination” and “Racial, ethnic, or cultural concerns” are two presenting problems that therapists can choose from a comprehensive checklist of more than 40 problem areas. Clinicians can “check all that apply” within the list of concerns. “Anxiety” and “Depression” have historically been assessed as the most common primary presenting problems experienced by college student seeking services (2019 Annual Report, p.15). Examining a large national sample of 82,685 clients from 98 college counseling centers during the 2018-2019 academic year, CCMH found that clinicians identified Discrimination as a presenting problem for 0.7% of clients and Racial, ethnic, or cultural concerns was selected for 2.7% of clients. Zooming in, it was discovered that the frequency of these presenting concerns varied considerably between majority and minority identity groups. CCMH has outlined the findings below (Please note, these data reflect the rates in which clinicians identify Discrimination and Racial, ethnic, or cultural concerns as primary presenting problems for students entering treatment and do not measure the percentage of clients who report a history of these problems):

COVID-19 has resulted in widespread concern about college-student’s mental health – both during the spring of 2020 and forecasting into the future. Recent surveys of college students have suggested that that college students’ psychological distress increased significantly following the COVID-19 response and shutdowns in March 2020. Because CCMH continuously pools national data from students seeking mental health services at college counseling centers, we were curious to see if our data support this hypothesis.